Agenda and minutes

            Mr Brian Cockbill asked whether the Board’s Terms of Reference covered the care of individuals living in Swindon and receiving medical care outside of its boundaries and vice-versa.

            Carol Burns (Chair, Swindon Health Watch) that the Health Watch organisation was the body to which any such care issues should be referred.  She noted that there was a network of Health and Well Being Boards across the country that liaised not only with each other but also area teams, the QSG and the NHS to ensure the commissioning of services covered all people in an appropriate manner.  The Chair noted that officers would examine the Board’s Terms of Reference to ensure they covered the issue Mr Cockbill had raised.

            Mr Cockbill thanked the Board and noted that where Swindon’s strategies varied from neighbouring Board’s in other areas there might be confusion other variances of policy.  The Chair noted that in instances where care of an individual was undertaken outside of Swindon or vice-versa staff would need to liaise with the appropriate authorities.

To receive the minutes of the meeting held on 10^th July 2013.

            Resolved – That the minutes of the meeting held on 10^th July 2013 be confirmed and signed as a correct record.

            The Board considered a joint report of the Acting Director of Public Health and Head of Commissioning – Children and Adults concerning (a) the funding arrangements and amounts to be transferred from the National Health Service (NHS) to local authorities during the period 2014/15 and 2015/16, as set out in the June 2013 Spending Review, (b) interim arrangements for 2013/14 where it is proposed that £2.75 million is transferred from NHS England to Swindon Borough Council.  The Acting Director of Public Health noted that there was the opportunity to improve the lives of vulnerable people within the Borough.

            Councillor Mattock raised the issue of the Working Group to recommend how the funding is allocated in 2014/15 and suggested that this might be via an officer working group who would bring forward recommendations for consideration and that this could be set around the NHS planning framework.

            Jennifer Howells noted that given there are early discussions underway on the draft planning guidance some financial details might not be known until December and that it would be hard for the Board to make decisions until it knew the true financial position.  Sue Wald pointed out the current guidance on transformation included the Dilnot implementation and some of this would occur in 2014/15 in respect of social care.

            Resolved – (1) The report and the implications of the 2013 Comprehensive Spending Review and future funding transfers from the NHS to Local Authorities be noted.

                        (2) That an officer working group comprising representatives of Swindon Borough Council and the Swindon Clinical Commissioning Group be established to make recommendations to this Board and the Adult and Children’s Joint Commissioning Board in respect of how money transferred from the NHS to Swindon Borough Council is allocated in 2014/15.

            (3) That the Cabinet and the Governing Body of the Swindon Clinical Commissioning Group be recommended that:

(a) the conditions associated with the transfer of NHS funds to Swindon Borough Council be noted and agreed; and

(b) the proposed spend of £2.753 million of transferred money, as set out in paragraph 3.16 of the joint report of the Acting Director of Public Health and Head of Commissioning – Children and Adults, be agreed.

            The Acting Director of Public Health submitted a report setting out (a) the findings of the Hepatitis B and C Joint Strategic Assessment, (b) seeking support for the recommendations arising form the study, and (c) raising awareness of the health care related needs of those infected with Hepatitis B and C in Swindon.

            The Board received a presentation from Penny Marno, Public Health Speciality Registrar on:

·      The assessment, how it was undertaken and its key findings.

·      The transfer of Hepatitis B and C within the community.

·      Treatments available for Hepatitis B and C.

·      The number, in the region of 500-800 people who suffered from either Hepatitis B and C in Swindon with 13 cases in 2012/13.

·      Issues with reaching those affected to ensure treatment and education was provided.

·      The current provision of treatment to Swindon patients and improvements in diagnosis and treatment.

·      Raising awareness of Hepatitis B and C in Swindon, its symptoms and treatment within the wider community.

·      Raising awareness of issues relating to Hepatitis B and C in Swindon within the medical community.

·      Sections of the community most at risk of contracting Hepatitis B and C in Swindon.

·      The provision of Swindon care in line with NICE guidance.

·      The evidence base for the report and its recommendations.

            Councillor Ray Ballman asked about the current provision of treatment in Oxford of Swindon patients, and whether, as many belonged to vulnerable groups whether provision of treatment in Swindon might not be better. The Board was informed that the standard of care provided to Swindon patients in Oxford was very good.  Given the numbers involved for a specialist service the question of maintaining the standard of service within Borough might not be feasible.  Officers could examine this issue and the feasibility of Swindon based provision and include it in feedback to the Board for consideration.

            Resolved – (1) That the Cabinet and Swindon Clinical Commissioning Group be recommended:

(a) to note and agree the recommendations set out in Appendix 1 of the Hepatitis B and C  JSNA Bulletin attached to the report of the Acting Director of Public Health, and

(b) to support the development of an action plan for the implementation of the recommendations referred to in (1) above.

            (2) That officers submit an annual update on all on-going issues, including Hepatitis B and C, relating to the Joint Strategic Needs Assessment.

            The Board Director, Commissioning submitted a report setting out (a) the Learning Disability Partnership Board to monitor progress against the recommendations in the Learning Disability Joint Strategic Needs Assessment, and (b) the work being undertaken to complete Swindon’s submission to the new Joint Health and Social care Self-Assessment for learning disabilities.

            Councillor Ray Ballman introduced key issues set out in the report and in relation to the work of the Learning Disability Partnership Board:

·        The work undertaken by the Learning Disability Partnership Board in relation to health, the first area covered.

·        The Learning Disability Partnership Board’s next area of work- unemployment and the issue of the employment of disabled people.  It was noted that the Chair of Inswindon would be attending this meeting.

·        The Police and Crime Commissioner who would be attending the meeting considering issues relating to crime.

·        The Learning Disability Partnership Board which was a large and diverse body would, once it had completed this work, submit a report to the Health and Wellbeing Board setting out key issues and conclusions for discussion.

·        The Learning Disability Partnership Board was keen to fruitfully engage the Health and Wellbeing Board and the Adult’s and Children’s Joint Commissioning Board.

            Members congratulated Councillor Ray Ballman and the Learning Disability Partnership Board on its work to date and the progress report which was informative and accessible.  The Board discussed:

·        The importance of the work being undertaken by the Learning Disability Partnership Board.

·        What work with communities could be undertaken to improve lives and make systems simpler.  The Director of Commissioning indicated his willingness to attend a meeting to help facilitate a better understanding of how the Health and Wellbeing Board could interact.

·        Work that might be necessary to improve participation in direct payment personal budgets; the take up of which was currently low. The Board noted this issue had been raised with SEQAL and the Avon and Wiltshire Mental Health Trust and that in the last year the number of participants had risen from 700 to around 1,200.

·        Current work to try and identify ways of including one off requests (ie for equipment).

·        Taking the report to Healthwatch Swindon for discussion.

·        The low figure for employment identified within the report and whether this was partly the result of the current national position and in particular the competition of youth unemployment.

·        The need for employers to be proactive in their employment practices and whether Influence could assist with highlighting this issue locally.

·        The role of Health Ambassadors was discussed and it was noted that the Adult and Children’s Joint Commissioning Board would discuss personal budgets at their next meeting.

·        It was noted that it had been discussed at the last LEP meeting and that avenues such as volunteering might prove beneficial when seeking employment.

            Resolved – (1) That progress made with recommendations in the Learning Disability Joint Strategic Needs Assessment be noted.

            (2) That progress of the Learning Disability Partnership Board’s work and in implementing the recommendations in the Learning Disability Joint Strategic  ...  view the full minutes text for item 22.

            The Acting Director of Public Health submitted a report concerning the Healthy Weight Strategy which has been refreshed and extended to cover the period 2013-2015.

            The Board received a presentation highlighting the following points:

·        The strategy developed and brought up to date was for the period 2013-15.

·        The statistics of obesity in Swindon and in particular 9.9% obesity rate for over 5’s and 19.2% for 10-11 year olds.

·        The strategy recognised that obesity is caused by an imbalance between that we eat and what we do.

·        The consultation process undertaken to date.

·        Prevention work and the creation of an understanding of lifestyle on health.

            The Board discussed the strategy and work undertaken on the prevention of obesity in both the current plan and its predecessor and why obesity levels appeared to be continuing to rise.  It also discussed the evidence base system approach being undertaken and how the current plan was being informed by best practice and success in other areas, and the work being undertaken with schools.  The Board also discussed the use of national statistics to inform local adult obesity rates and the use of the school nursing team in the collation of childhood data.

            The Board noted that work still needed to be undertaken in respect of increasing physical activity in schools and in involving academies in promoting the strategy. The Board considered it key to imbed the key principles at a primary age to maximise the chance of making life altering changes to prevent obesity and the illnesses that this often led to.  This was increasingly important following the end of the national support for the Healthy Schools programme. Swindon however continues to operate a local Healthy Schools programme. The Council might also have a wider role in the provision of safe play areas and through planning controls on fast food outlets in sensitive areas and housing design.

            It was felt to be important that any data provided must be accurate and stand up to scrutiny in order that the Board and the public could have confidence in the decisions made.  The Board asked that the officers meet with Tony Ranzetta (Clinical Commissioning Group) to investigate the difference in the interpretation of data to ensure Swindon Borough Council and the Swindon Clinical Commissioning Group agreed on any data supplied to the group (or the reasons why there was a difference in interpretation) prior to submission to this Board.

                        Resolved – (1) That, subject to additional information on fats food outlets and planning being included within the Healthy Weight Strategy, the Cabinet and the Governing Body of the Clinical Commissioning Group be recommended to approve the Healthy Weight Strategy for 2013-2015.

            (2) That the Board welcomes the current Healthy Weight Action Plan  and the activity underway to raise awareness of achieving and maintaining a healthy weight across Swindon to achieve the aims of the strategy.

            The Acting Director of Public Health submitted a report setting out (a) the Local Government Declaration on Tobacco Control and (b) the rationale and work undertaken in creating the declaration.

            The Cabinet Member for Health and Adult Social Care introduced the report and confirmed the Council’s support for the aims and objectives.

            Resolved - (1) That the Cabinet and the Governing Body of the Swindon Clinical Commissioning Group  be recommended to support and welcome the Leader of Swindon Borough Council’s intent to sign up, on behalf of Swindon Borough Council, to the Local Government Declaration on Tobacco Control.

            (2) That Swindon Borough Council and the Swindon Clinical Commissioning Group be requested to consider how, through their respective organisations, they can promote the objectives of the declaration and make a clear commitment to tackle the harmful effects of tobacco.

            The Chair introduced Stuart MacPherson, the Wiltshire Police and Crime Commissioner, and asked the Board to consider approving his appointment to the current membership.  Mr MacPherson had been appointed to the Wiltshire Health and Wellbeing Board and the Chair indicated that there were advantages of including the Police and Crime Commissioner on this Board as well both in the contribution he could bring to its work and for consistency purposes.

            Mr MacPherson thanked the Chair and outlined the crime and health connection within the areas of work he was undertaking.

            Resolved – That the Wiltshire Police and Crime Commissioner be appointed as a member of this Board and that this Board’s Terms of Reference be amended accordingly.